Effect of an oculomotor rehabilitation program for subacute brain injury patients with ophthalmoplegia: a case-control study

Abstract

Purpose Examining the effects of an oculomotor rehabilitation program in subacute brain injury patients presenting with external ophthalmoplegia. Methods This case-control study included 33 patients with subacute brain injury accompanied by external ophthalmoplegia (15 cases, 18 controls) from a hospital rehabilitation ward. Participants underwent comprehensive rehabilitation for 8 weeks. The patients participated in an oculomotor rehabilitation program, which involved inducing pursuit, fixation, saccade, and vergence for 20 min daily, 6 days a week for 8 weeks. We assessed improvements in the angle of strabismus; visual function index (VFI), which evaluates inconvenience in daily life; and diplopia after 8 weeks in the two groups using statistical methods. Results The program resulted in an immediate strabismus angle improvement (p < 0.001). Strabismus angle change over the 8-week period was significantly higher (p < 0.001) in patients (22.9 ± 12.3°) than in control participants (8.3 ± 7.6°). VFI change was significantly greater (p = 0.003) in patients (7.1 ± 5.1 points) than in control participants (2.7 ± 2.4 points). The patients exhibited significantly higher diplopia improvement rates while looking straight ahead and in the direction of paralysis than did control participants (p = 0.021 and p = 0.037, respectively). Conclusion This program improved external ophthalmoplegia without any specialized environmental configurations or personnel, which ensures wide clinical applications. IMPLICATIONS FOR REHABILITATION Our oculomotor rehabilitation program improved external ophthalmoplegia in subacute brain injury patients. The program promotes pursuit, fixation, saccades, and vergence. The patients lay in the supine position and it places a little burden on them. The program can be completed within 20 min daily, requires no special environmental configurations, and can be performed by anyone.